Individual provider Active NPI

Edward Perrotti-Sousis, MSW, LCSW

  • Clinical Social Worker
  • Pittsfield, MA
National Provider Identifier
1699350082
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090993-01 Issued in NY
Practice address
75 Church Street
Floor 6, Suite 22
Pittsfield, MA 01201
Phone
(518) 212-7295
NPI assigned
Mar 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 090993-01 NY Primary

Addresses

Primary practice location

75 Church Street
Floor 6, Suite 22
Pittsfield, MA 01201

Mailing address

334 Fenn Street
Pittsfield, MA 01201-3214
Phone (413) 499-0412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
090993-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Haven Clinical Current Accepting new patients
The Brien Center for Mental Health and Substance Abuse Services Inc. PastSince Mar 1, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1699350082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 FENN STREET",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012013214",
            "telephone_number": "413-499-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CHURCH STREET",
            "address_2": "FLOOR 6, SUITE 22",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "01201",
            "telephone_number": "518-212-7295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERROTTI-SOUSIS",
        "first_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-16",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090993-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.